Active NPI
Randolph Wadsworth Jr.
- Family Nurse Practitioner
- Latrobe, PA
National Provider Identifier
1730589243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP014111
- Practice address
- 1 Mellon Way
Ehmg Hospitalist Group
Latrobe, PA 15650-1197 - Phone
- (724) 537-1801
- Fax
- (724) 532-6830
- NPI assigned
- Sep 3, 2014
- Last updated
- Apr 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP014111 | PA | Primary |
Addresses
Primary practice location
1 Mellon Way
Ehmg Hospitalist Group
Latrobe, PA 15650-1197
Mailing address
520 Jefferson Ave
Suite 400
Jeannette, PA 15644-2538
Phone (724) 527-8060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP014111 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491264000000",
"number": "1730589243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 JEFFERSON AVE",
"address_2": "SUITE 400",
"city": "JEANNETTE",
"state": "PA",
"postal_code": "156442538",
"telephone_number": "724-527-8060",
"fax_number": "724-522-4002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MELLON WAY",
"address_2": "EHMG HOSPITALIST GROUP",
"city": "LATROBE",
"state": "PA",
"postal_code": "156501197",
"telephone_number": "724-537-1801",
"fax_number": "724-532-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADSWORTH",
"first_name": "RANDOLPH",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-03",
"last_updated": "2017-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP014111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latrobe, PA
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- Micah R Wallace, PA-C
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.